Class matters: US versus UK measures of occupational disparities in access to health services and health status in the 2000 US National Health Interview Survey
Class matters: US versus UK measures of occupational disparities in access to health services and health status in the 2000 US National Health Interview Survey
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DOI：
10.2190/jkre-ah92-edv8-vhyc
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发表时间：
2005-01-01
影响因子：
3.4
通讯作者：
Soobader, MJ
中科院分区：
文献类型：
--
作者：
Krieger, N;Barbeau, EM;Soobader, MJ
为了为当前关于职业阶层是否与健康不平等存在因果关系的辩论提供信息，作者使用了2000年美国国家健康访谈调查的数据来比较获得医疗服务、社会经济资源和健康状况方面的职业差距，使用了(1)英国新的国家统计社会经济分类(NS-SEC)，前提是劳动合同类型(工薪与小时工资)和阶级地位(雇主、自雇、监督和非监督雇员)，以及(2)传统的美国职业类别，前提是地位和技能。分析包括所有有职业和种族/族裔数据的劳动适龄成年人(25岁至)(N=22,500)。与蓝领和白领相比，NS-SEC级别5的人获得医疗服务的机会不足、贫困和低教育的风险是级别1的两倍，而且在这两种衡量标准下，健康状况最差的人从事的工作获得医疗保健的机会最少。对劳动收入和工作场所健康保险的控制显著减少了医疗服务差距，特别是在NS-SEC措施方面，从而意味着工作的结构特征与解决美国健康不平等所需的资源和福利具有因果关系。
To inform current debates over whether occupational class is causally linked to health inequities, the authors used data from the 2000 U.S. National Health Interview Survey to compare occupational disparities in access to health services, socioeconomic resources, and health status, using (1) the United Kingdom's new National Statistics Socio-Economic Classification (NS-SEC), premised on type of labor contract (salaried vs. hourly wage) and class position (employer, self-employed, supervisory and non-supervisory employee), and (2) the conventional U.S. occupational categories, premised on status and skill. Analyses included all working-age adults (age 25 to 64) for whom data on occupation and race/ethnicity were available (N = 22,500). Risk of inadequate access to health services, poverty, and low education were two times greater for persons in NS-SEC class 5 versus class 1, compared with blue-collar versus white-collar, and for both measures persons with the worst health status were in jobs that afforded the least access to health care. Controlling for earned income and workplace health insurance markedly reduced health service disparities, especially for the NS-SEC measure, thereby implying structural characteristics of jobs are causally relevant for resources and benefits necessary to address health inequities in the United States.